Analysis of the influence of teachers' teaching input on teaching effect satisfaction in medical colleges / 中华医学教育探索杂志

Objective:To investigate and analyze the influencing factors of teachers' teaching input status on teaching effect satisfaction in medical colleges.Methods:A total of 782 teachers of basic medicine and clinical medicine in a local medical college in Hebei Province were selected by multi-stage stratified random sampling method. The (mean ± standard deviation) was used to describe the status quo of teachers' teaching input, and the t- or F-test was used for inter-group comparison. The influence of teaching input on teaching satisfaction was analyzed by multiple linear regression. Results:The teaching input of medical college teachers was affected by different demographic characteristics, among which the teaching time input was affected by gender, age, professional title, teaching age, educational background and category (all P<0.05), the emotional input was affected by age,professional title,teaching age,educational background and category (all P<0.05), and the teaching ability development input was affected by age, professional title, teaching age and category (all P<0.05). There was a correlation between the population characteristics of teachers and the teaching input and the satisfaction of teaching effect, and the teaching age of teachers is negatively correlated with the satisfaction of teaching effect ( β=-0.057, P<0.05). There were positive correlations between teaching satisfaction and teaching effect (all P<0.05), including the number of lesson preparation hours, the number of weekly teaching hours, the degree of teaching attention, the degree of medical teaching research balance, the learning and expansion of teaching skills, and the difference of teaching observation reflecting teaching input. The teaching input of basic medicine teachers was significantly higher than that of clinical teachers (all P<0.05). Conclusion:It is suggested that medical colleges and clinical teaching bases should pay attention to the construction of teacher echelon, optimization of policies and measures to balance the relationship between medical education and research, construction of the support system of teachers' teaching work input to improve teachers' professional efficacy, and the building of a professional development community of teachers integrating basic medical teachers and clinical teachers to improve the training quality of medical students.

Predictive value of foramen ovale size on pain recurrence after percutaneous balloon compression / 中南大学学报(医学版)

OBJECTIVES@#Primary trigeminal neuralgia (PTN) is a common cranial nerve disease in neurosurgery, which seriously endangers the physical and mental health of patients. Percutaneous balloon compression (PBC) has become an effective procedure for the treatment of PTN by blocking pain conduction through minimally invasive puncture. However, the recurrence of facial pain after PBC is still a major problem for PTN patients. Intraoperative balloon shape, pressure and compression time can affect the prognosis of patients with PBC after surgery. The foramen ovale size has an effect on the balloon pressure in Meckel's lumen. This study aims to analyse the predictive value of foramen ovale size for postoperative pain recurrence of PBC by exploring the relationship between foramen ovale size and postoperative pain recurrence of PBC.@*METHODS@#A retrospectively analysis was conducted on the clinical data of 60 patients with PTN who were treated with PBC in Department of Neurosurgery, Affiliated Hospital of Chengde Medical College from November 2018 to December 2021. We followed-up and recorded the Barrow Neurological Institute (BNI) pain score at 1, 3, 6 and 12 months after operation. According to the BNI pain score at 12 months after surgery, the patients were divided into a cure group (BNI pain score I to Ⅱ) and a recurrence group (BNI pain score Ⅲ to Ⅴ). The long diameter, transverse diameter and area of foramen ovale on the affected side and the healthy side of the 2 groups were measured. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used for analysis the relationship between the recurrence of pain and the long diameter, transverse diameter, area of foramen ovale on the affected side, and aspect ratio, transverse diameter ratio, area ratio of foramen ovale on the affected side to healthy side in the 2 groups.@*RESULTS@#At the end of 12 months of follow-up, 50 (83.3%) patients had pain relief (the cured group), 10 (16.7%) patients had different degrees of pain recurrence (the recurrence group), and the total effective rate was 83.3%. There were no significant differences in preoperative baseline data between the 2 groups (all P>0.05). The long diameter of foramen ovale on the affected side, the long diameter ratio and area ratio of foramen ovale on the affected/healthy side in the cured group were significantly higher than those in the recurrence group (all P<0.05), and there were no significant differences in the transverse diameter and area of foramen ovale on the affected side and the transverse diameter ratio of foramen ovale on the affected/healthy side between the 2 groups (all P>0.05). The ROC curve analysis showed that the AUC of the long diameter of foramen ovale on the affected side was 0.290 (95% CI 0.131 to 0.449, P=0.073), and the AUC of aspect ratio of foramen ovale on the affected side to healthy side was 0.792 (95% CI 0.628 to 0.956, P=0.004). The AUC of area ratio of foramen ovale on the affected side to healthy side was 0.766 (95% CI 0.591 to 0.941, P=0.008), indicating that aspect ratio and area ratio of foramen ovale on the affected side to healthy side had a good predictive effect on postoperative pain recurrence of PBC. When aspect ratio of foramen ovale on the affected side to healthy side was less than 0.886 3 or area ratio of foramen ovale on the affected side to healthy side was less than 0.869 4, postoperative pain recurrence was common.@*CONCLUSIONS@#Accurate evaluation of the foramen ovale size of skull base before operation is of great significance in predicting pain recurrence after PBC.

Key issues and trends of health manpower management in the world / 中华医院管理杂志

Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.

Progress and challenge of health human resources development in China / 中华医院管理杂志

The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.

Application of quality control circle program in post stroke depression at the recovery phase / 中国基层医药

Objective To explore the effect of Quality Control Circle(QCC) on patients in the recovery phase with post stroke depression at rehabilitation therapy.Methods 80 patients in the recovery phase with post stroke depression were collected.According to the digital table, they were randomly divided into control group and QCC group,40 cases in each group.All the patients got treatment as rehabilitation medical care routine, rehabilitation exercise and medical treatement.And patients of QCC group received extra QCC management.The activities of daily living(Barthel Index Scale),severity of depression(Hamilton Depression Scale HAMD),rehabilitation exercises compliance were evaluated in the two groups.Results After intervention, the scores of ADL,HAMD and rehabilitation exercises compliance in the control group were (33.50±6.22)points,(22.23±3.30)points,(2.70±1.32)points,respectively,which in the QCC group were (54.13±8.84)points,(14.75±4.14)points,(4.45±0.90)points,respectively.The scores of activities of daily living(ADL)(t=15.06,26.03,all P<0.01) and rehabilitation exercises compliance(t=1.78,12.2,all P<0.01) had been improved, which in the QCC group was more obvious(t=12.10,6.90,all P<0.01)).The depression scores in both two groups were decreased(t=13.35,25.78,all P<0.01),and the decrease in the QCC group was significantly higher than that in the control group(t=8.93,P<0.01).Conclusion QCC application in post stroke depression at the recovery phase can effectively reduce the degree of depression, improve patients' ADL and rehabilitation exercise compliance.

Effects of Electrolyte on the Stability of Neonatal Parenteral Nutrition / 中国药房

OBJECTIVE:To study the effects of electrolyte on the stability of the neonatal parenteral nutrition. METHODS:Under room temperature(25 ℃),the neonatal parenteral nutrition containing only monovalent or bivalent ion electrolyte(10% So-dium chloride injection,10% Potassium chloride injection,25% Magnesium sulfate injection,and Calcium gluconate injection) and containing both monovalent and bivalent ion electrolyte were investigated by the change of appearance to determine the pH val-ue,insoluble particles and the size and distribution (polydispersity index,PDI) within 24 h. RESULTS:The pH of the nutrition with electrolyte was over 5 and also met the quality requirements;there were no precipitate,flocculation and discoloration in the appearance;the neonatal parenteral nutrition containing only monovalent ion electrolyte appeared a small amount of hanging wall phenomenon for 24 h,but did not appear demulsification phenomenon;the neonatal parenteral nutrition containing only bivalent ion electrolyte appeared a small amount of hanging wall phenomenon and demulsification phenomenon for 24 h;the neonatal paren-teral nutrition containing both monovalent and bivalent ion electrolyte appeared a small amount of hanging wall phenomenon and de-mulsification phenomenon for 12 h and the hanging wall phenomenon was more obvious for 24 h. Meanwhile,a size bigger than 5μm microns and particle size bigger than 25 μm microns of insoluble particles appeared,and both the average particle size and PDI value were higher than those in the previous two situations(P<0.05). CONCLUSIONS:As more and more monovalent and biva-lent ion electrolyte being added into the neonatal parenteral nutrition,especially divalent ion electrolyte,the stability of the neona-tal parenteral nutrition decreases,which behaves as a phenomenon that the size of grains and the number of insoluble particles in-crease.

Expression changes in fractalkine induced by focal cerebral ischemia and reperfusion in rats / 中华老年医学杂志

Objective To investigate the expression changes of fractalkine (FKN)in focal cerebral ischemia and reperfusion penumbra,and to explore its variation law and role in the inflammation of cerebral ischemia-reperfusion injury.Methods The cerebral ischemia reperfusionmodel was established by intraluminal thread occlusion in the middle cerebral arteries occlusion (MCAO).FKN protein expression in focal cerebral ischemia and reperfusion penumbra was detected by immunohistochemistry and Western blot.Results The results of immunohistochemistry stain showed that the chemokine FKN was expressed in a low level in the normal group and the sham operation group,and there were no significant differences among the two groups (P＞ 0.05).Compared with the humbers of FKN in normal group (37.03± 6.28) in focal cerebral ischemia and reperfusion penumbra,the expression of FKN in model group was increased after 3 h of reperfusion (48.58±7.29) (P＜0.05),peaked at 24 h (112.08±8.26) (P＜0.05],and then decreased gradually at day 7 after reperfusion,but had no significant difference (40.73 ± 4.02) (P＞ 0.05).FKN was expressed in a low level in the sham operation group (0.527±0.002),then up-regulated after 3 h of reperfusion [(0.598±0.004),P＜0.05],peaked at 24 h [(0.833±0.005),P＜0.05],maintained a high level till 48 h after reperfusion [(0.735±0.002),P＜0.05],and return to baseline level at day 7 after reperfusion [(0.533±0.004),P＞0.05].Conclusions Fractalkine is upregulated after focal cerebral ischemia/reperfusion,and has a dynamical change,which indicates that fractalkine might involve in the inflammatory process after cerebral ischemia-reperfusion injury.

An analysis of prognostic factors in patients suffering from acute lung injury/acute respiratory distress syndrome complicated with Yangming Fushi syndrome：a report of 206 cases from multiple centers / 中华危重病急救医学

ObjectiveTo investigate the risk factors of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) complicated with Yangming Fushi syndrome.Methods A prospective study was conducted. From August 2009 to July 2013, 206 patients with Yangming Fushi syndrome combined with ALI/ARDS were enrolled in the intensive care units ( ICUs ) of the following five hospitals: Tianjin Nankai Hospital, Dongzhimen Hospital Affiliated to Beijing Traditional Chinese Medicine University, General Hospital of Tianjin Medical University, the First Affiliated Hospital of Dalian Medical University, and Wuxi Third People's Hospital in Jiangsu Province. According to the mortality occurring in ICU, the patients were divided into death group and survival group. The gender, age, acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) score within the first 24 hours after admission, the length of invasive mechanical ventilation, usage of vasoactive agents, ratio of operative intervention, the length of stay in ICU, application of continuous renal replacement therapy ( CRRT ), amount of blood transfusion, the level of C-reactive protein ( CRP ), lactulose/mannitol ( L/M ) ratio, the number of organs with dysfunction, oxygenation index ( PaO2/FiO2 ), levels of lactate and serum creatinine ( SCr ) of both groups were recorded. Logistic regression analysis was used to look for the independent risk factors of death of patients. Results There were 124 cases with severe acute pancreatitis ( SAP ), which was the most common disease with manifestation of Yangming Fushi syndrome combined with ALI/ARDS, accounting for 60.19% of all the patients. During the period of hospitalization in ICU, 171 patients survived and 35 died, and the mortality rate was 16.99%. The risk factors of the two groups were analyzed by variable analysis, and it was shown that compared with those in survival group, the age ( years: 57.26±16.23 vs. 48.07±13.48, t = 3.544, P = 0.000 ), APACHE Ⅱ score ( 20.83±9.73 vs. 12.61±6.63, t = 4.777, P = 0.000 ), the length of invasive mechanical ventilation ( days: 10.97±7.71 vs. 6.91±2.48, t = 2.555, P = 0.015 ) and the number of dysfunction organs ( 3.11±1.21 vs. 1.60±1.34, t = 6.222, P = 0.000 ) in death group were significantly higher. The level of PaO2/FiO2 [ mmHg ( 1 mmHg = 0.133 kPa ): 218.56±64.90 vs. 244.58±85.10, t = -2.024, P = 0.044 ] in the death group was significantly lower than that of the survival group, while the length of ICU stay ( days: 14.33±10.81 vs. 9.11±7.37, t = 2.600, P = 0.010 ), the usage rates of CRRT [ 28.57% ( 10/35 ) vs. 15.20% ( 26/171 ), χ2 = 3.968, P = 0.046 ], vasoactive agents [ 28.57% ( 10/35 ) vs. 12.28% ( 21/171 ), χ2 = 6.511, P = 0.011 ], and blood transfusion ratio [ 42.86% ( 15/35 ) vs. 23.39% ( 40/171 ), χ2 = 7.042, P = 0.008 ] were all obviously higher in the death group than those in the survival group. There were no statistically significant differences in gender, number of operation, the levels of CRP, L/M ratio, lactate and SCr between the two groups ( all P > 0.05 ). Multivariate logistic regression analysis showed that age [ odds ratio ( OR ) = 0.938, 95% confidence interval ( 95%CI ) = 0.898-0.980, P = 0.004 ], APACHE Ⅱ score ( OR = 0.914, 95%CI = 0.839-0.996, P = 0.041 ), the number of dysfunction organs ≥ 3 ( OR = 0.223, 95%CI = 0.066-0.754, P = 0.016 ), and the level of PaO2/FiO2 ( OR = 0.990, 95%CI = 0.982-0.998, P = 0.015 ) were independent risk factors for mortality. Conclusions The age, APACHE Ⅱ score, number of dysfunction organs ≥ 3 and the level of PaO2/FiO2 are of significance in predicting the prognosis of patients with Yangming Fushi syndrome combined with ALI/ARDS. Patients with risk factors of high mortality should be more carefully monitored and treated aggressively.

Relationships among psychological capital, social support and mental health of medical staffs / 中华行为医学与脑科学杂志

ObjectiveTo explore the relationships among psychological capital,social support and mental health of medical staffs.MethodsAccording to convenience sampling principle,101 medical staffs from one three-grade class A hospital in Hebei participated in the study.They were investigated with questionnaires such as Psychological Capital Questionnaire ( PCQ-24),Social Support Rating Scale (SSRS) and Symptom Checklist 90(SCL-90).Results①The scores of self-efficacy,hope,resilience and optimism were(3.73 ±0.58 ),(3.59 ±0.60),(3.81±0.49),(3.70 ± 0.32),all of which are higher than middle points.There were statistic difference in four subscales of psychological capital(P ＜ 0.05 ).Compared with nurses,doctors scored higher in self-efficacy ( (3.92 ±0.66),(3.59 ±0.48) ).The difference was significant(P＜0.05).Among different educational background there were also statistic differences(P ＜ 0.05 ).②Psychological capital was negatively related to the whole factors of SCL-90(P＜0.0l,or P ＜ 0.05 ),however,social support was negatively related to only part of it(P ＜0.05 ).③Psychological capital could negatively predict mental health(P ＜ 0.01 or P ＜ 0.05 ).ConclusionThis research outlines a strong relationship between psychological capital and mental health of medical staffs.But social support has no a significant impact on mental health.